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Preliminary Questionnaire

The Culture and Intensive English Program (CIEP) at the University of Northern Iowa (UNI) appreciates and welcomes your interest in representing and promoting our program. The CIEP has been teaching English and preparing students to continue with their academic studies at universities and to enhance their professional careers for almost 30 years. The University of Northern Iowa's commitment to putting "Students First" firmly established its reputation for providing first-rate educational experiences. The nation's most highly respected reporting organizations consistently rank UNI among the best for program quality, value and outcomes.

We value having the best consultants represent our interest. Therefore, we are selective in choosing our consultants and request that you complete this Preliminary Agent Questionnaire. The questionnaire is required and helps us decide if your firm is a good match for our program.

If you have any concerns about this questionnaire, contact Philip Plourde, CIEP Director at unicieppartners@uni.edu. Thank you.

Exact Official Name *

Address *

Placeholder

Email Address *

Telephone Number *

Fax Number

Skype Name (If applicable)

Website URL *

Address *

Name of CEO, Director, or lead consultant *

U.S. Federal Tax Identification Number (if applicable) *

If your agency uses or has used other names in the past, please provide them here:

How long has your firm been in business? *

Contact person (if different from above)

Contact person's information (Please list email, fax, and phone)

How many part time employees do you have? *

How many full-time employees do you have? *

What is your staff structure? Where do you fall in this structure? *

What are your business hours (Please include your time zone) *

How many days per week is your office open? *

Briefly describe the kind of training you provide your employees regarding placement of students in ESL programs? *

Does your staff attend a NAFSA or TESOL conference? *

Yes

No

List at least two educational consultants' organizations that you or your company belong to. *

Which other intensive English language programs doe you represent? please provide at least three different programs. *

What services do you provide? (Check all that apply) *

Placement (seeking admission to U.S. education programs, on behalf of prospective students)

Recruitment (seeking to attract students to particular institutions or programs)

Advising/Counseling (assisting students in deciding whether an education in the U.S. would help them attain their educational goals and whether it is practical to consider)

Publications

Placement in ESL programs

Job Placement

Travel Arrangements

Arranging home stays

Preparing students for visa interviews

Recruitment of other educational advisers and/or agents to work on behalf of a program

Do you provide any other services not listed above? Please specify. *

How do you market your services (check all that apply) *

Prepare your own brochures

Direct mail/email

Printed magazine ads

Organize exhibitions and fairs

Participate in exhibitions and fairs

Web advertising

Personal references from alumni

If you use any other promotional tools, please specify here. *

How many students have you placed in the U.S. in the past year? *

What minimum requirements do you request from prospective clients/students or for prospective schools? *

What is your target market? Type of student/client? Region(s) or countries? *

What kind of students do you typically send to the United States> *

Individuals

Groups

Professionals/Executives

Special Interest

List the native languages or nationality of the students you send. *

How much (in US Dollars) do you charge prospective students for brochures? *

How much (in US Dollars) do you charge prospective students for application forms? *

How much (in US Dollars) do you charge prospective students for advice? *

How much (in US Dollars) do you charge prospective students for help in completing the application process? *

How much (in US Dollars) do you charge prospective students for help in completing the visa process? *

How much (in US Dollars) do you charge prospective students after they have been officially admitted? *

Do you charge for any other services? Please specify.

If students are admitted to English language programs, do you also make arrangements for the students subsequent admission to university academic programs? *

Do you need to pay an extra fee for this subsequent service?

UNI offers conditional admission for both undergraduate and graduate enrollment. Do you have students interested in conditional admission? *

Do you explain to the students that they should expect to spend at least one semester at the institution which issued them the I-20? *

Yes

No

How do you become familiar with the schools you refer students to? *

Do you visit schools in the U.S.? *

If we provide full lodging, would you be willing to travel to the U.S. to learn about our educational service? *

How did you learn about CIEP? *

If you were referred to CIEP by another agents, please list the referee's name and contact information.

Have you been an agent for CIEP in the past? If yes, please list the year of the most recent valid contract. *

Please list the names and email addresses of three individuals at academic institutes who have received students from you in the past year. We will contact them on your behalf for a performance recommendation. *

Statement of Ethical Principles *

I have read and agree to the Statement of Ethical Principles established and implemented by NAFSA: Association of International Educators. I understand that should me or my agency by approved by CIEP, I will abide by these ethics. In addition, I understand that even if I become an agent for CIEP, that I may receive commissions only for self-pay placements. I understand that this questionnaire/survey does not in anyway stipulate an agency or consultant relationship but rather this is used solely to gain information about the level and quality of services I might provide CIEP in the future.

Please read the Statement of Ethical Principles from NAFSA: http://www.nafsa.org/Learn_About_NAFSA/Governance_Documents/Ethics_And_Principles/Statement_Of_Ethics/NAFSA_s_Statement_of_Ethical_Principles/

Please type your name here, confirming that you agree to the above statement *

Date *

月

日

年

If you would like to include promotional materials with your questionnaire, please upload the files here. *